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Vol. 38. Issue 3.
Pages 120-123 (July - September 2012)
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Vol. 38. Issue 3.
Pages 120-123 (July - September 2012)
Caso médico forense
Traumatismo penetrante de cráneo y muerte diferida: a propósito de un caso
Skull penetrating trauma and delayed death: presentation of a case
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8613
M. Carmen Rebollo-Soriab,
Corresponding author
carmen.rebollo@xij.gencat.cat

Autor para correspondencia.
, Amadeo Muntané Sáncheza, Yessica Velasco Díaza, Daniel Fontes Caraméa, Josep Castellà Garcíab
a Departament de Neurorradiologia, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
b Servicio de Patología Forense, Instituto de Medicina Legal de Cataluña, Barcelona, España
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Resumen

Presentamos un caso de traumatismo penetrante en el cráneo por arma blanca de morfología desconocida con muerte diferida. El estudio necrópsico puso de manifiesto herida cutánea cicatrizada y lesión encefálica modificada por hemorragias y edema secundarios a la lesión. Las pruebas de imagen (TC y reconstrucción 3D) efectuadas durante el proceso asistencial fueron útiles para localizar el orificio óseo en el cráneo, necesario para valorar las características del arma homicida. Hubo que modificar la técnica de autopsia ampliando la retirada del cuero cabelludo y del músculo temporal derecho, puesto que la lesión ósea quedaba por debajo del plano de apertura habitual, y de otra forma hubiera pasado desapercibido. Esto pone de manifiesto que las pruebas de imagen son útiles tanto para la toma de decisiones clínicas como para facilitar la valoración médico-forense posterior, por lo que es importante la colaboración entre los servicios clínicos en general, y de radiología en particular, con los servicios de patología forense.

Palabras clave:
Traumatismo penetrante craneal
Objeto punzante
Técnicas de imagen
Tomografía computarizada craneal
Reconstrucción 3D
Abstract

A case is presented involving a skull penetrating trauma with an unknown sharp weapon with a delayed death. The autopsy showed skin injury as a scar and brain injury modified by haemorrhage and swelling. Imaging techniques such as CT scan and 3D reconstruction performed during the healthcare process were useful to find the skull orifice, and needed to assess the characteristics of the homicide weapon. We had to modify the autopsy technique by removing a larger area of anterior scalp and right temporal muscle, because the injured bone was lower than the usual level, and otherwise it would not have been noticed. This shows that imaging techniques are useful for making clinical decisions and for medico-legal investigations, so once again we would like to emphasise the importance of collaboration between clinical services in general, and Radiology Service in particular, with the Forensic Pathology Service

Keywords:
Skull penetrating trauma
Sharp weapon
Imaging techniques
Computed tomography scan
3D reconstruction

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